英国骨科医生参与糖尿病足护理的情况。

The engagement of orthopaedic surgeons in diabetic foot care in England.

作者信息

Robinson A H N, Garg Parag, Kirmani Sayyied, Allen Patricia

机构信息

Department of Trauma and Orthopaedics, Cambridge University Hospital NHS Trust, Cambridge, UK.

Department of Trauma and Orthopaedics, Kettering General Hospital, Kettering, UK.

出版信息

Bone Jt Open. 2022 Aug;3(8):618-622. doi: 10.1302/2633-1462.38.BJO-2022-0025.R1.

DOI:10.1302/2633-1462.38.BJO-2022-0025.R1

PMID:35909341

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9422902/

Abstract

AIMS

Diabetic foot care is a significant burden on the NHS in England. We have conducted a nationwide survey to determine the current participation of orthopaedic surgeons in diabetic foot care in England.

METHODS

A questionnaire was sent to all 136 NHS trusts audited in the 2018 National Diabetic Foot Audit (NDFA). The questionnaire asked about the structure of diabetic foot care services.

RESULTS

Overall, 123 trusts responded, of which 117 admitted patients with diabetic foot disease and 113 had an orthopaedic foot and ankle surgeon. A total of 90 trusts (77%) stated that the admission involved medicine, with 53 (45%) of these admissions being exclusively under medicine, and 37 (32%) as joint admissions. Of the joint admissions, 16 (14%) were combined with vascular and 12(10%) with orthopaedic surgery. Admission is solely under vascular surgery in 12 trusts (10%) and orthopaedic surgery in 7 (6%). Diabetic foot abscesses were drained by orthopaedic surgeons in 61 trusts (52%) and vascular surgeons in 47 (40%).

CONCLUSION

Orthopaedic surgeons make a significant contribution to both acute and elective diabetic foot care currently in the UK. This contribution is likely to increase with the movement of vascular surgery to a hub and spoke model, and measures should be put in place to increase the team based approach to the diabetic foot, for example with the introduction of a best practice tariff.Cite this article: 2022;3(8):618-622.

摘要

目的

糖尿病足护理给英国国家医疗服务体系（NHS）带来了沉重负担。我们开展了一项全国性调查，以确定英国骨科医生目前参与糖尿病足护理的情况。

方法

向2018年全国糖尿病足审计（NDFA）中接受审计的所有136家NHS信托机构发送了一份问卷。该问卷询问了糖尿病足护理服务的结构。

结果

总体而言，123家信托机构做出了回应，其中117家接收糖尿病足疾病患者，113家有骨科足踝外科医生。共有90家信托机构（77%）表示患者入院涉及内科，其中53家（45%）的入院患者仅在内科治疗，37家（32%）为联合收治。在联合收治的患者中，16家（14%）与血管外科联合，12家（10%）与骨科手术联合。12家信托机构（10%）的患者仅在血管外科入院，7家（6%）在骨科手术入院。61家信托机构（52%）的糖尿病足脓肿由骨科医生引流，47家（40%）由血管外科医生引流。